Permit rt CITY OF TIGARD ELECTRICAL PERMIT
�' COMMUNITY DEVELOPMENT "i `` 1 Permit#: ELC2016-00178
016
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2'39//MIMI Date Issued: 2510 BA0
� Parcel: 2S1046A00100
Jurisdiction: Tigard
Site address: 12085 SW 135TH AVE 70
Project: Greenfield Apts.#70 Subdivision: None Lot: None
Project Description: 5 ckts: rewire bedroom and replace devices due to fire.4/4/16,REPRINTED to add(1)service.
Contractor: SQUIRES ELECTRIC Owner: GREENFIELD VILLAGE LLC
657 SE YAMHILL ST BY NANCY L COWGILL
PORTLAND, OR 97214 STOEL RIVES LLP
900 SW 5TH AVE STE#2600
PORTLAND, OR 97204
PHONE: 503-252-1609 PHONE:
FAX: 503-253-5831
FEES
Quantity Description Date Amount
1 ea Services or Feeders-200 04/06/2016 $100.70
Specifics: amps or less
5 crt Branch Circuits w/Purchase 04/06/2016 $37.10
Type of Use: MF Service or Feeder
Class of Work: ALT 1 ea 12%State Surcharge- 04/06/2016 $16.54
Electrical
Type of Const: 45 Misc Administration Fee 04/06/2016 $45.00
Occupancy Grp:
Total $199.34
Required Items and Reports(Conditions)
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTI • regon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 rough OA 952- 0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued B : /� �. t� Permittee Signature: _
OWNER INSTALLATION ONLY
The installation is being made on property I own which is not intended for sale,lease or rent.
OWNER'S SIGNATURE Date:
CONTRACTOR INSTALLATION ONLY
SIGNATURE OF SUPR.ELEC' �i. Date:
LICENSE NO.
Call 503.639.4175 by 7:00 a.m.forthe next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
! i
Electrical Permit Application FOR OFFICE CSE()NIX
City Of Tigard DatoBy, 7 <�4 Il ipennid;
(-he-do/0 t l Z D
N 13125 5W Hall Blvd.,Tigard,OR 97223 e"" Plan Revic
Phone: 503.718.2439 Fax: 503.59$191 C lam1f'�.f C 1 C Date/ByRelated Permit#:
Inspection Line: 503.639.4175 lam• A•j ReadyDateJBy' tune: ' 621 See Paget for -``
I& ARL, Internet: www,tigard-or.gov , ' Notified/Method: Supplemental Information •
` r
. 5" ::7 .'�mo;,.•gf C?.--Zi.: u
, a,' a r. .+t. - _'', ilt.e .14401.101" ,4: •',',:.❑Nevi, construction V Addition/alteratioqefelANQPleacc that apply(submit2 sets of plans w/items checked):
0 Service
or feeder 400 amps or more 0 Building over three stories.-.-
® � where the available fault current ❑tv#arinas and boatyotds .( '
❑Demolition El Other: 5t
•� exceeds 10,000 amps at 150 volts or []Floating buildings, •:+
[] 1- nd 2-family dwelling ❑Commercial/industrial ❑Accessory building less to ground,or exceeds 14,000 0 Commercial-use agncultur . i
�� 4 y n Fire form ,ll outer installations. buildings.
1 ulti-family ❑Master builder 1-J Other: ID Fire pomp, ❑Ins[allarion of 150 KVA or,'
c; ,�vip,,�
e tfM Olr�+ h,r, 6f,Yd':.• '¢ it' 4i:t0at.r` ",..�i, .?l•r g Y Y larger separately derived '.
.�"•,.. INW4!'� �'I ; „`'�,.� �r ❑timer cne system. ,
' q w 1�Addition of new motor load of system
Job#:_ Job site address,l2o♦ S,S W \`�� �! Yr 100HP or more, ❑••A. •,E,"1-2",..1_3
city/S(flIC/71 P: ❑Sia Or more residential units. Occupancy.
❑Health-care facilities. 0 Recreational vehicle parks.
•
Suite/blclg./ipt.#: Project name: I ika-, a. _IA '` _ 0 Hazardous locations. U Su pply voltage far more than
9 Service or feeder 600 amps or more. 600 volts nominal.
Cross street/directions to job site: y.,�' u ��� ,N �
.'�dILLL�..�`:�n� .t:"S-5�b' �� .:.wFr,E1��L 11lI!;F,-rih i,I I I `',7,
Dc rpt lion I t•. Each Taal "
New residential single-or multi-family,dwelling unit.
Subdivision: .. I Lot#: Includes attached garage.
Tax map/parcel#: 1,000 sq.ft or less ■ 168.54 4
• �, Ea.add'I 500 sq.ft.or portion 33.92 1
. 4 1) e t�iia Fro a O y, '..4 '''' w i' 18Jlaw ^++I �' ti('�:4i Limited energy,residential 75,00 •2
1 ale.
e. 0. 4.-� - Sec-4.1'&F _ell (with above sq.0.)
Limited energy,multi-family •i
r • ,V '- F LC 2_r l r^ - OO : residential(with above sq,ft.) 75,00 .2:
v `� �i Renewable Ener
1, . . 79 rp Energy ❑ Set Pie 2
PRo ''' r''Q,tA,hlcd w NcaWw l+nv t u W w F .i a7e. Services or feeders installation,alteration,aisWor relocation
Name: 200 amps or less 1 1 100.70 ', 2
Address: 201 amps to 400 amps I 133.56 2
401 amps to 600 amps I 200,34 • 2
" 'N/Slide/7IP: 601 amps to 1,000 amps r 301.04 •Z
..,One; ( ) Fax: ( ) Over 1,000 amps or volts 552.26 2
Temporary services or feeders installation,alteration,and/or l
Emai is
relocation I
Owner installation:This installation is being made on property that I own which is not 200 amps or less l 59.36 :1
intended for sale, lease,rent,or exchange,according to ORS 447,449,670,and 701. 201 amps to 400 amps 1 125,08 2
Owner signature: Date: 401 amps to 599 amps I 168.54 2
" ' ,g $ �,•J Branch circuits-new,alteration or extension,per incl
,'-'i, .:;'' ...77,2::••i'i� '11t.� s iii q "' Q , ih:.,v , .� ,....,d t P Pt
'"""s'I'�•'-' �"-' °jm"= � vc" A.Fee for branch circuits with�
Business!lame:Squires Electric,Inc. above service or feeder fee, 7 42 2
Contact name: each branch circuit
B.Fee for branch circuits without
•Address:657 SE Yanthill St. service or feeder fee,rot56.18 2
branch circuit
City/Slate/1IP:Portland,OR 97214 Each add'l branch circuit 7.42 2
Miscellaneous(service or feeder not included)
Phone:1503)252-1609 Fax: :(503)253-5831 Each manufactured or modular ` 67.84 I -2
dwelliu 4� wi Reconnectnservice and/or feeder
+ �� Om only . 67.84 2
Email:Andrew@SquiresElectric.com
Tt(' tAii -i ,ti$, �/ he �it2^ ., Pump or irrigation circle 1 67.84 2
Business name:Squires Electric,Inc. Sign or outline lighting 67.84 2
Signal circuit(s)of limited-energy
Address:657 SE Yamhill St. _panel,alteration,or extension. O See Page 2 2
City/State:ZIP: Portland,OR 97214 Each additional inspection over allowable In any of the above
,additional inspection(1 hr mm) 66.25/hr
Phone:(51)3)252-1609 Fax:(503)253-5831 Investigation(1 lir min) ',90,00/ttr
Email:Andrew@SquiresElectrie.i om
Industrial plant(1 hr rain) 178.18/hr
Inspections for which no fee is '40,00/hr
CCB Lie.: 135085 lectri 0 Lie.: 26-.101C Suprv. Lie.: 4882S s cificall listed(I6 hr min
f^�nv.Electrician si.nature,requ cd: �'
Sub otal: t (r)
- .at name: Joe Sqt•resDate: .. /;1 rl (00 Plan Review Required(25%of permit!fee):
. 1111r
( State surcharge(12%of permit fee): 0. (ot Yv
Authorized signature: r— TOTAL PERMIT EE
/I This permit application expires if a permit i4 not obtained,vithin 180
Print name: Joe Squires pate' �, t / 1 6, days after it has been accepted as complete.
f ' Number of inspections allowed per permit.
1:\Buddiot\Perntil,'ELC_PermitApp ELR_e •.doc Rev O0/17/2015 440-40 t5r(11/05/COM/WPO
Location:
Record Type:
Inspection Type:
Result:
Comments:
Inspection Date:
Record ID:
Inspector:
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
12085 SW 135TH AVE 70, TIGARD, OR, 97223
Commercial - Electrical
199 Electrical final
PASS - No C of O
ELC2016-00178
Jeff Grove
Violation Summary:
Inspector Contractor